<style>
  .{{$template|escape:'html'}}_table1 {
    width: 100%;
    text-align: left;
  }
  .{{$template|escape:'html'}}_td1 {
    width: 170px;
    height: 24px;
    text-align: right;
    font-weight:bold;
    padding: 4px 10px 0 30px;
    white-space: nowrap;
    vertical-align: top;
  }
  .{{$template|escape:'html'}}_td2 {
    height: 25px;
    padding: 0 0 0 10px;
    text-align: left;
  }
  .{{$template|escape:'html'}}_td3 {
    width: 100%;
    height: 30px;
    padding-left:10px;
    font-weight:bold;
    text-align: left;
  }
  .{{$template|escape:'html'}}_td4 {
    height: 40px;
    text-align:right;
  }
  .{{$template|escape:'html'}}_td5 {
  }
  .{{$template|escape:'html'}}_inputText {
    width: 260px;
    height: 16px;
  }
  .{{$template|escape:'html'}}_selectText {
    width: 264px;
    height: 22px;
  }
</style>

<script src="jsrequest.php?script={{$template|escape:'html'}}" type="text/javascript"></script>
<script type="text/javascript">
  <!--
    if (document.addEventListener) {
      document.addEventListener('DOMContentLoaded', init, false);
    }
    window.onload = init;

    function init() {
      if (!document.getElementById || !document.createElement || !arguments || arguments.callee._loaded) {
        return;
      }
      arguments.callee._loaded = true;
      var gui = AbsClient.gui('{{$template|escape:'javascript'}}');
      new HandleClient(gui, JSON.parse('{{$user|escape:javascript}}'), JSON.parse('{{$date|escape:javascript}}'), JSON.parse('{{$options|escape:javascript}}'), JSON.parse('{{$message|escape:javascript}}'));
    }
  //-->
</script>
<div class="{{$template|escape:'html'}}_table1">
  <table cellPadding="0" cellSpacing="0">
    <tr>
      <td style="vertical-align:top;padding:0 50px 25px 0;">
        <table class="{{$template|escape:'html'}}_table1" cellPadding="0" cellSpacing="0">
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Given Names</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_name_first_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Surname</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_name_family_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">File Folder No.</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_file_folder_num_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Date of Birth</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_date_birth_date"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Nationality</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_nationality_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Gender</td>
            <td class="{{$template|escape:'html'}}_td2"><select class="{{$template|escape:'html'}}_selectText" id="{{$template|escape:'html'}}_gender_select"></select></td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Partner Status</td>
            <td class="{{$template|escape:'html'}}_td2"><select class="{{$template|escape:'html'}}_selectText" id="{{$template|escape:'html'}}_partnership_status_select"></select></td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
        </table>
      </td>
      <td style="vertical-align:top;">
        <table class="{{$template|escape:'html'}}_table1" cellPadding="0" cellSpacing="0">
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Address</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_addr1_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5">
              <span style="margin: 0 0 0 50px;font-weight:bold;">Contract</span>
              <select disabled="true" style="margin: 0 0 0 5px;width: 100px" id="{{$template|escape:'html'}}_contract_select"></select>
              <input disabled="true" value="Print" type="button" style="margin: 0 0 0 5px;font-size:11px" class="button" id="{{$template|escape:'html'}}_print_btn"></input>
            </td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1"></td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_addr2_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1"></td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_addr3_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Contact No. 1</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_phone1_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Contact No. 2</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_phone2_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Contact No. 3</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_phone3_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Email</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_email_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
        </table>
      </td>
    </tr>
    <tr>
      <td style="vertical-align:top;">
        <table class="{{$template|escape:'html'}}_table1" cellPadding="0" cellSpacing="0">
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Passport No.</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_pass_num_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Passport Expiry Date</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_pass_date_exp_date"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Passport Issue Date</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_pass_date_issue_date"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Country of Birth</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_country_birth_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
        </table>
      </td>
      <td style="vertical-align:top;">
        <table class="{{$template|escape:'html'}}_table1" cellPadding="0" cellSpacing="0">
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Referee Person/Sub Agent</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_agent_text"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Staff</td>
            <td class="{{$template|escape:'html'}}_td2"><select class="{{$template|escape:'html'}}_selectText" id="{{$template|escape:'html'}}_staff_select"></select></td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">First Contact Date</td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="text" class="{{$template|escape:'html'}}_inputText" id="{{$template|escape:'html'}}_first_contact_date_date"></input>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1">Contents and Price</td>
            <td class="{{$template|escape:'html'}}_td2">
              <textarea style="width: 260px" rows="4" id="{{$template|escape:'html'}}_first_contact_detail_text"></textarea>
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
          <tr>
            <td class="{{$template|escape:'html'}}_td1"></td>
            <td class="{{$template|escape:'html'}}_td2">
              <input type="button" class="button" style="margin: 10px 0 20px 177px" value="Save Client" id="{{$template|escape:'html'}}_save_button" />
            </td>
            <td class="{{$template|escape:'html'}}_td5"></td>
          </tr>
        </table>
      </td>
    </tr>
  </table>
  <div id="{{$template|escape:'html'}}_more_div" align="center" style="padding:0 60px 0 20px;"></div>
</div>
